MEDICARE: BEVERLY CITY BOARD OF EDUCATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		NJ

General Provider Information

NPI Number	:	1043437387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY CITY BOARD OF EDUCATION

Provider Business Mailing Address
First Line	:	601 BENTLEY AVE
Second Line	:
City	:	BEVERLY
State	:	NJ
Zip	:	08010-1523
Country	:	US
Telephone Number	:	609-387-2810
Fax Number	:	609-387-0986

Provider Business Practice Location Address
First Line	:	601 BENTLEY AVE
Second Line	:
City	:	BEVERLY
State	:	NJ
Zip	:	08010-1523
Country	:	US
Telephone Number	:	609-387-2810
Fax Number	:	609-387-0986

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	DR. GLENN T. GRAY
Credential	:
Telephone Number	:	609-387-2810

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	08/22/2020

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Directions to “BEVERLY CITY BOARD OF EDUCATION ” Practice Location

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